MRCPsychmentor

Question 1

Which antipsychotics are most, least and sparing for hyperprolactinaemia?

Answer 1

Most:
- Risperidone
- Paliperidone
- Amisulpride
- Sulpride

Low risk
- Olanzapine
- Lurasidne
- Ziprasidone

Sparing:
- Clozapine
- Aripiprazole
- Asenapine
- Quetiapine

Question 2

Which SSRI’s are associated with least drug interactions

Answer 2

Citalopram (least) + Sertraline (second)

Question 3

What is pseudocyesis?

Answer 3

A condition where a woman believes she is pregnant when she is not - not couvade syndrome (conversion symptoms in partners of expectant women who are away they are not pregnant)

Question 4

Differentiate the phi-phenomenon from autokinesis?

Answer 4

Autokinesis - one single light in the darkness appears it is moving

Phi-phenomenon - rapid sequences of perceptual events that give the impression of movement Wh

Question 5

Which part of the cell is devoted to the manufacture of lipids?

Answer 5

Smooth endoplasmic reticulum

n.b the Nissl substance that contains the rough endoplasmic reticulum and ribosomes is the site of protein synthesis

Question 6

Amitriptyline or haloperidol - which is more likely to precipitate heart block?

Answer 6

Amitriptyline - TCA’s more associated with heart block

Antipsychotics more associated with torsades des pointes and VF

Question 7

Why may U waves been seen in anorexia nervosa?

Answer 7

They are produced in hypokalaemia

Question 8

What makes up the MMSE?

Answer 8

Orientation to place
Orientation to time

Registration - 3 items to name

Attention and concentration - serial 7’s or WORLD backwards

Recall

Language
- name a pencil and watch
- repeat sentances no ifs and or buts
- give a 3 stage command

Visual construction
- draw intersecting pentagons

Question 9

Name some anti-depressants low risk to cause hyponatraemia

Answer 9

• Moclobemide (MAOIs)
• NaSSa
• Buproprion
• Agomelatine

n.b TCAs are moderate risk, SSRI/SNRI are high risk for hyponatraemia

Question 10

What enzymes are involved in the aetiology of alcohol brain damage?

Answer 10

Transketolase

Also:
- Pyruvate dehydrogenase (PDH)
- Alphaketoglutarate dehydrogenase (KGDH

Question 11

What schizophrenia related protein codes for an enzyme involved in the biogenesis of lysome related organelles and is found in brain and muscle?

Answer 11

DNTB1 - Dysbidin - on chromosome 6

Question 12

How do V2 and V3 exit the skull?

Answer 12

V2 - round foramen
V3 - ovale foramen

I - cribiform plate
II - optic canal
III, IV, V1, VI - SOF
VII + VIII = internal auditory canal
IX, X, XI - jugular foramen
XII - hypoglossal canal

Question 13

How do Chimeras differ from Moasics

Answer 13

Mosaics - different cell types from one zygote
Chimera - different cell types from more than one zygote

Question 14

Are cannabinoid receptors found in the brainstem?

Answer 14

No

Question 15

What does the Clifton Assessment Procedure assess?

Answer 15

Quality of life, cognitive needs and physical dependency levels in the elderly
It includes a behavioural and cognitive scale
Can be used for hospital and community settings

Question 16

Which APOE increases risk?

Answer 16

APOE4 - on chromosome 19

Question 17

Is CSF more acidic than plasma?

Answer 17

Yes

Question 18

How often do the following EPSEs occur per year of antipsychotic exposure:

a) Dystonia
b) Pseudo-parkinsonism
c) Akasthesia
d) Tardive Dyskinesia

Answer 18

a) 10%
b) 20%
c) 25%
d) 5%

Akasthesia highest incidence - 25%
Parkinsonism second - 20%
Dystonia 3rd - 10%
Tardive Dyskinesia 4th - 5%

Question 19

Are endophenotypes state dependent?

Answer 19

No - endophenotypes should be present regardless of illness/remission state

Other features:
- Heritable
- Be present in higher rates of disease families > general population
- Cosegregate with the disorder within families
- Endophenotypes must segregate within the illness in the general population
- Must be reliably be measured

Question 20

What scale does the AMDISEN measure?

Answer 20

Lithium toxicity

Question 21

What is a test like the Wisconsin card sorting test for objects?

Answer 21

Goldstein-Scheerer object sorting task

It is a test if abstract function

Question 22

What is the blood supply to the hypothalamus?

Answer 22

Anterior communicating artery?

Question 23

What is the blood supply to the basal ganglia?

Answer 23

Medial cerebral artery

Question 24

What MRI findings may be present in MS?

Answer 24

White matter hypointensities

Question 25

The anti-emetic effect in chlorpromazine is due to…

Answer 25

D2 blockade in the CTZ

Question 26

For OCD which symptom domains respond poorly to SSRIs and CBT?

Answer 26

Sexual/religious rituals and hoarding rituals

Note symmetry/ordering rituals have a high genetic risk

Question 27

How long does cannabis, cocaine, methadone, heroin be found on a UDS?

Answer 27

Cannabis 1-3 days if occasional up to 30 days if chronic
Cocaine 6-8hrs with metabolites 2-4 days
Amphetamine up to 48hrs
Heroin 1-3 days, Methadone up to 7 days

Question 28

Which neurological disorder has substance P been linked to?

Answer 28

Huntington’s - lower levels

Question 29

Which condition has neurotensin been linked to?

Answer 29

Psychosis

Question 30

In Fragile X intelligence deficits correlate to….

Answer 30

the degree of chromosomal damage

Question 31

Name some urgent treatments for trancylpromine?

Answer 31

Phentolamine or Chlorpromazine: alpha-adrenergic antagonist - these lower BP within 5 mins if given IV

Question 32

A craboxyl ester group is present on….

Answer 32

depot antipsychotics

Question 33

Large family size and smoking during pregnancy are high risk factors for….

Answer 33

language development delay

Question 34

Hyperhomocysteinaemia is associated with…

Answer 34

Dementia